Pulmonary myiosis in chronic obstructive pulmonary diseases and effect of some medicinal plants extracts

Pulmonary mycosis is not uncommon finding in patients complaining of chronic obstructive pulmonary diseases. Excess use of corticosteroids enhances the infection. Aspergillus and Candida species were the predominant strains isolated. The isolated fungi were sensitive [in vitro] in different degrees to different medicinal plants extracts

Extrapulmonary tuberculosis in Minia governorate in years 1985-1990

A study of incidence of extrapulmonary tuberculosis in six years [1985-1990] was carried out in EL-Menia Chest Hospital. The number of subjects examined was 16925, of which 2353 [14%] were diagnosed as tuberculosis. Out of the 2353 tuberculous cases, 535 [22.7%] had extrapulmonary lesions. Tuberculosis lymphadenitis accounts for 39.1%. There were 188 cases [35.1%] with pleural effusion, 23 cases [43%] with genitourinary tuberculosis, 42 cases [7.9%] with skeletal tuberculosis, [2.6%] with meningeal tuberculosis, 18 cases [3.4%] with peritoneal tuberculosis, and 20 cases [3.7%] with miliary tuberculosis. From 1985 to 1987, the number of tuberculous cases [pulmonary or extra pulmonary] declined slowly [from 340 to 279 and from 93 to 68, respectively] then increased again in the subsequent 3 years. The proportion of extrapulmonary tuberculosis among all patients with tuberculosis by age, was found to be highest in youngs and generally to decrease with increasing age, higher among female than male patients and higher among rural than urban natives. Considerable differences in susceptibility to different sites of extrapulmonary tuberculosis by age, sex, region of origin were found. The reasons of these differences remain largely unexplained

Pulmonary mycosis in chronic obstructive air way diseases and effects of some medicinal plant extracts

Pulmonary mycosis is not uncommon finding in patients complaining of chronic obstructive airway diseases. Excess use of corticosteroids enhances the infection. Candida and Aspergillus species were the predominant strains isolated. The isolated fungi were sensitive [in vitro] in different degrees to different medicinal plant extracts

Medical antireflux treatment for asthma associated with gastroesophageal reflux

Thirty patients with non-allergic bronchial asthma associated with gastroesophageal reflux [GER], were studied before and after 9 weeks of antireflux medical therapy [ranitidine HCl]. All patients were subjected to full clinical history and examination, chest roentgenogram, ventilatory function tests, and tests to confirm GER [Bernstein test, Tuttle test, upper gastroesophageal endoscopy including taking biopsy from lower esophageal mucosa for histopathological examination]. Esophageal and pulmonary symptoms scores were recorded weekly. Endoscopic evidence of GER was shown in 63% of cases, while histopathologically esophagitis was proved in 96%. 9-week antireflux medical treatment was associated with rapid and dramatic response of reflux symptoms in 80% of cases and with more delayed and less dramatic improvement in pulmonary symptoms in 87% of case, evidenced subjectively by decline of both esophageal and pulmonary symptoms scores. Objectively esophageal erosions were diagnosed endoscopically in 16 out of 19 patients and healed completely. Ventilatory function tests also significantly improved [P <0.01]. It was concluded that there is a subset of patients in whom bronchoconstriction is triggered by GER. Treatment of the reflux in such patients improved their asthma

Comparative study between the spectrum and drug sensitivity of pathogens causing empyema thoracis in the period of 1974-1977 and 1991-1993 in upper Egypt

159 cases of post-pneumonic empyema thoracic were included in this study. They were divided into 2 groups. Comparative study between both groups revealed no difference as regard aged and sex predilection. Bacteriologically, positive cultures of pus collected from group I for aerobic bacteria were obtained in 80.6% of cases. Staph. aureus played a major role in causing empyema thoracic [43.5%]. Other isolates were: Pneumoccoci [syn. strept. pneumoniae] [25.8%], Pseudomonas sp. [14.5%], Klebsiella sp. [12.9%], Strept. pyogenes and Proteus [8% for each] and Diptheroid [4%]. Nothing recorded about anaerobic bacteria. In group II, positive cultures of pus for aerobic and anaerobic bacteria were obtained in 43.3 and 42.1%, respectively. Although Staphylococcus aureus headed the aerobic bacterial list yet, its frequency decreased to 23.7%. Other isolates were Klebsiella sp. [11.3%], Strept, pyogenes [7.2%], Strept. pneumoniae [6.2%], E. coli [5.1%], Proteus sp. [4.1%] and Pseudomonas sp. [2.1%]. Contrary to group I, Strept. pneumoniae and Pseudomonas sp. played minor roles. As regard anaerobic bacteria, the commonest was Bacteroids sp. [18.4%], followed by Peptostreptococcus [10.5%], Peptococcus [7.9%] and Fusobacterium was the least common [5.3%]. Results of sensitivity tests showed that the different isolated pathogens were sensitive to different antimicrobial drugs, so, the choice of antibiotic must usually be determined by the results of culture and sensitivity testing

Cell-type diagnosis of advanced central bronchogenic carcinoma without restoring to major thoracotomy

Seventy-three patients [forty-five males and twenty-eight males] who had central bronchogenic carcinoma were diagnosed. The methods utilized in the diagnosis were revised to decide a rapid diagnostic approach without restoring to major thoracotomy. According to the radiologic features, they were classified into total lung atelectasis [six patients], para- cardiac shadow [thirty patients], hilar and para-hilar shadows [sixteen patients], para-tracheal shadow [sixteen patients] and more than of the mentioned features [five patients]. Bronchoscopically, they were classified into those with visualized lesions [22 patients] and non-visualized lesions [51 patients]. Palpable scalene lymph gland was positive in all specimens [100%] regardless of the radiologic or the bronchoscopic classification. This is in contrast to non-palpable node which produced negative diagnosis in all specimens. Bronchoscopic biopsy was positive in all cases with visualized lesions, while blind biopsy was positive in 9% of non-visualized lesions. The patients with non- visualized growth and non-palpable scalene node could be diagnosed safely by anterior mediastinotomy without restoring to major thoracotomy. This procedure has many advantages

Primary lung cancer in patients below the age of 40 years in upper Egypt

Thirty-two patients aged from 18 to 39 years were managed for bronchogenic carcinoma in Menia and Assiut University Hospitals in the period from July 1988 to December 1993. All patients were symptomatic at time of diagnosis. Initial clinical examination, radiologic features and bronchoscopic findings that indicated advanced disease tumor were found in 27 patients. Yielded positive results of exfoliative cytology were low [sputum 13%, bronchial wash 28% and pleural fluid 9%]. Adenocarcinoma was found in 46.8% of the patients, small cell carcinoma in 28.1%, alveolar cell carcinoma in 9.4%, mixed adenosquamous and large cell carcinomas in 6.3% for each and lastly, squamous cell carcinoma in 3.1%. According to TNM definition in new international staging for lung cancer [1986], none had stage II or IIIa, but nine patients had stage IIIb and twenty-two had stage IV, while one patient only had stage I tumor disease. Resectability rate was 3%

Why surgery is preferable in management of solitary pulmonary nodules?

This study included 108 patients who had solitary pulmonary nodules. 65 had malignant lesions [Group I] and 43 had nonmalignant nodules [Group II]. Bronchogenic carcinoma headed the list of malignant lesions [91%], while granulomas either specific or nonspecific headed the list of nonmalignant nodules [60%]. After thoracotomy, it was proved that the clinical, radiological, laboratory and bronchoscopic studies achieved the following In group I [GI] correct preoperative diagnosis in 3%, false negative diagnosis in 12% and the remaining 85% their lesions were suggestive of malignancy but without definite proof. In group II [GII] correct preoperative diagnosis was achieved in 20 nodules [granuloma [18], hamartoma [one] and pulmonary arteriovenous fistula [one]]. The preoperative diagnosis was different from post operative diagnosis in 6 cases. False diagnosis as bronchogenic carcinoma was reported in one case. The remaining lesions [16], their benign nature was established after thoracotomy. Surgery is the line of choice in dealing with such cases to explore, identify and resect the lesion whenever possible

Value of lysozyme [muramidase] in pleural effusion and serum of children

The study included 55 patients with pleural effusion [18 transudate, 27 bacterial empyema and 10 tuberculous exudate] their ages ranged from 1-10 years. Also 20 apparently healthy children of matched age and sex were taken as control. No significant difference was found in the levels of serum lysozyme between disease and control groups. There was a significant increase in pleural fluid lysozyme levels in bacterial empyema than in transudate or tuberculous exudates [P = 0.000, P = 0.001] respectively. There was also a significant increase in pleural fluid lysozyme in cases of tuberculous effusion when compared with transudate group [P = 0.002]. Pleural fluid-to-serum lysozyme [PL/SL] ratio was 0.81 +/- 0.11 mg/dL in cases of transudate, 11.69 +/- 2.48 mg/dL in bacterial empyema and 1.98 +/- 0.75 mg/dL in tuberculous effusion groups. The existence of a raised PL/SL ratio in cases of tuberculous and bacterial empyema groups suggested important local synthesis of lysozyme. Comparing patients of tuberculous effusion with patients of transudate a PL/SL ratio higher than 1.4 showed a sensitivity of 90%, specificity of 100%, positive predictive value of 100%, negative predictive value of 94.7% and accuracy of 96.4% for discrimination of tuberculous effusion. All of these suggest that the determination of pleural fluid lysozyme and PL/SL ratio is a simple, fast method for obtaining corroborative information in the differential diagnosis of tuberculous pleurisy from transudate